SUBSECTION 3 Compound purgatives

Compound medicines that purge melancholy are taken through either the upper or the lower parts of the body: through the upper parts at the mouth or nostrils. At the mouth they are either swallowed or not swallowed; those swallowed are liquid or solid. Liquids include compound wines of hellebore, squill or sea onion, and senna; squill wine and hellebore wine, which Quercetan praises so highly “for melancholy and madness, either taken internally or applied externally to the head with small pieces of linen dipped into it while warm.”

Other examples are squill oxymel and Quercetan’s greater and lesser hellebore syrups; the same author’s broom syrup for hypochondriacal melancholy; compound syrups of chicory, fumitory, polypody and so on; and Heurnius’ purgative rooster broth.

Some object to these syrups as extremely harmful, as appears in Udalrinus Leonorus’ letter to Mattioli. They appeal to Hippocrates: “Move and treat what is concocted, not what is crude”—no raw things should be used in medicine. But Mattioli rejects and thoroughly refutes this in the following letter. Many juleps, potions and recipes are compounded from these substances, as you will find in Hildesheim’s Gleanings, book 2; Heurnius, book 2, chapter 14; George Skenkius’ Practice of Italian Medicine and elsewhere.

Solid purgatives are confections, electuaries and pills, taken alone or compounded with other ingredients: preparations of lapis lazuli or Armenian stone, Indian pills, fumitory pills and so on. There is Hamech’s confection, which most approve, although Solenander attacks it bitterly in section 5, consultation 22, as do Rondelet in his Apothecary’s Workshop, Fernel and others. There are Diasena, Diapolypodium, Diacasia, Diacatholicon, Wecker’s electuary of epithyme and Ptolemy’s Hierologadium, from which various recipes are made daily.

Aetius, 22, 33, recommends Rufus’ Hiera. Trincavelli, book 1, consultation 12, approves of Hiera: “I find no better medicine,” he says; he says he finds no better medicine. Heurnius adds aggregate pills, epithyme pills and Indian pills. Mesue describes, in the Florentine Antidotary, “pills I would not be without,” Cochia pills with hellebore, Arabian pills, fetid pills and pills of the five kinds of myrobalans. These are more specifically suited to melancholy, without meanwhile excluding turbith, manna, rhubarb, agaric, Elescophe and others less specifically suited to this humour.

For, as Montaltus maintains in chapter 30, and Montanus also, “choler too must be purged, because it feeds black bile”: choler must be purged because it nourishes the other humour. Some hold the opinion maintained long ago by Erasistratus and Asclepiades, against whom Galen argues, “that no medicine purges only one humour, but all alike, or whichever is nearest.” Most therefore combine several single substances and compounds in the recipes and special preparations devised here, to purge all the humours generally as well as this one.

Some prefer potions to pills for purging this humour because, as Heurnius and Crato observe, “this fluid is drawn out with difficulty by a dry remedy”: dry remedies do not draw this fluid out so easily. As Montanus advises in consultation 25, “all drying medicines must be rejected, such as aloes, Hiera and pills of every kind,” because the disease is dry in itself.

I could insert many recipes for prescribed potions, boluses and the like, together with their doses. But these are familiar to every good physician; and I am reluctant to incur Foreest’s censure in On Urines, book 3, chapter 6, “against those who divulge and publish medicines in their native language.” I also fear giving some uninformed reader an opportunity to experiment on himself without a good physician’s consent.

Medicines not swallowed but merely held in the mouth include gargles, commonly used after a purge when the bowels are open and loose. There are also apophlegmatisms, or masticatories, held and chewed in the mouth: gentle ones such as hyssop, oregano, pennyroyal, thyme and mustard; and strong ones such as pellitory, pepper, ginger and so on.

Those taken into the nostrils, called errhines, are liquid or dry: pimpernel juice, onions and so on; castoreum, pepper, white hellebore and the like. To these you may add scented preparations, perfumes and fumigations.

Those administered through the lower parts are enemas, strong or weak; suppositories of Castile soap or honey boiled to a firm consistency; or stronger ones made of scammony, hellebore and so on. All these are used and prescribed for this disease in various circumstances, as will be explained in the proper place.